Practice Activity-A Answer Key for Introduction to Food Packages Observe how food package assignment is conducted in your clinic. Answer the following questions for each certification that you observe. 1. Was a full assessment done prior to food package assignment? 2. Were there any special concerns that had to be addressed for food package assignment? 3. What information that was gathered was helpful in determining the food package for the participant? Practice Activity-B 1. Observe a CPA help a new participant select foods for their food package. (Observe an appointment for a woman or child.) How did the CPA explain the options for whole grains? How did the CPA explain the options for canned beans, dry beans or peanut butter? 2. Observe a CPA explain how to select WIC foods at the store. Describe how to use the Cash-Value Fruit and Vegetable voucher at the store. Describe how to select a WIC allowed juice.
Skill Check- #1 Use the WIC Shopping Guide to answer the following questions. 1. What are the criteria for selecting WIC allowed fresh fruit? Allowed: any variety, whole or cut. Organic is ok Not allowed: No items from salad bar, party trays, fruit basket, no decorative fruits, no dried fruit or nuts 2. What are the criteria for selecting WIC allowed frozen vegetables? Allowed: plain without white potatoes, any package type or size (except single serving), regular or low sodium, organic ok, yams and sweet potatoes ok No added sugar, no white potato products, no added butter or fats, no sauces or cheese, no mixtures with pasta, rice or other items, no single serving sizes 3. Which canned tomato products are not allowed? Any with added sugar, soups, salsa, pasta, sauces, any with added fats or oils 4. WIC allowed juice must have 120% Vitamin C. 5. Which whole grain items may be purchased in bulk? Brown rice or oatmeal 6. WIC allowed brands of bread must be purchased in 16 oz. loaf size. 7. Which canned bean products are not allowed? With added fats or oils, meats. Baked beans, pork and beans or chili beans, refried beans, soup mixes, organic, green or wax beans 8. WIC allowed peanut butter must be purchased in 15 to 18 oz. jar. 9. WIC provides Skim or 1% milk for women and children 2 years of age. 10. Cheese must be purchased in packages 8 oz. or larger.
Skill Check-#2 1. A mom of a Fully-breastfed infant (receiving no formula) is eligible for which food package? 2. A woman pregnant and fully-breastfeeding an infant up to 1 year of age is eligible for which food package? Food Package 7 3. An infant 8 months old with no qualifying conditions is eligible for which food package? Food Package 2 4. A three-year-old child is eligible for which food package? Food Package 4 5. A mom of a Some-breastfed infant is eligible for which food package? Food Package 6 Practice Activity C Practice Activity-C 1. Observe a CPA certify a breastfeeding mom/baby dyad. How did the CPA assess the breastfeeding? What probing questions were used? 2. Observe food package assignment for the certification above. How did the CPA work with the mom to assign a food package that supports mom s breastfeeding goals? Which food packages were assigned for the mom and baby?
Skill Check-#3 1. Why is it important to carefully assess breastfeeding and give no formula or the minimal amount of formula needed? So that there is little or no impact on the mother s breast milk supply 2. The amount of formula a Fully Formula-fed infant (non-breastfeeding) receives changes depending on baby s age. What are the three age groups and amount of formula each age group receives? Base answers on Similac Advance powder formula can sizes. 0-3 months: 9 cans maximum, 4-5 months: 10 cans maximum 6-11 months: 7 cans maximum 3. Why do formula maximums decrease at 6 months of age? Babies start eating other foods. Decrease in formula keeps the food package cost neutral. For breastfeeding babies, decrease in supplemented formula better supports breastfeeding. 4. Why are complementary foods added to the food package at 6 months? To enhance the nutritional value of the food package. Infants are developmentally ready for different foods and textures at this age. 5. Why do breastfed infants receive infant meats It is a value added food that provides added iron and zinc in a highly bio-available form. 6. Why do breastfed infants receive larger quantities of infant foods? Value added foods to promote breastfeeding. 7. Describe some ways to offer infant foods to older infants who may be interested in more textured foods. Mix with regular table foods Mix with finely chopped meats to provide moisture
Add to infant or cooked cereal Use to supplement family meals that don t include many infantappropriate foods. 8. For which situations might it be appropriate to assign a ready-to-feed formula? Water supply is unsanitary Refrigeration is lacking Difficulty preparing formula Formula needed is only available as ready-to-feed Best fits with baby s medical condition 9. In Food Package 2, two pounds of bananas replace 16 ounces of infant fruits and vegetables. 10. Mostly-breastfed infant receives how many jars of fruits and vegetables with no bananas? With bananas? 32 jars with NO bananas 28 jars WITH bananas Skill Check-#4 1. Which food package provides 2 pounds of whole grains? Food Package 4 2. What is the Fruit and Vegetable cash-value voucher amount for FP 4? FP 5? FP 6? FP 7? FP 4: $6 voucher FP 5: $10 voucher FP 6: $10 voucher FP 7: $10 voucher 3. What is the maximum amount of cheese that may be issued to a child (1 through 4 years of age) in FP4? 1 pound of cheese
4. Why is the amount of cheese limited in the food packages for children and women? To help decrease the amount of saturated and total fat in the child s diet. 5. The food package for children 2 years of age and older allows only skim or 1% milk. 6. Which food package requires medical documentation for issuance of soy-based beverage? Food Package 4 for children. 7. What milk options are available to women in Food Package 5 & 6 that do not require medical documentation? Evaporated milk, Powdered milk, Fresh goat, lactose free/lactose reduced milks, Soy-based beverage, Tofu 8. The substitution rate for tofu is 1 pound(s) of tofu for 1 quart(s) of milk. 9. Women pregnant with multiples are eligible for which food package? Food Package 7 10. Food Package 6 provides 0 pound(s) of whole grains. Skill Check-#5 Match the food package suggestions that you might offer when you hear the following statements: Statements: _6_ I d like my child to eat more vegetables, but I don t buy them because they will just go to waste. _10 I already have a lot of infant cereal in my cupboard. _4 He just doesn t like peanut butter that much. _7 _ Cow s milk doesn t seem to set very well with my daughter. I m not sure what she should drink. _5 _ I really dislike fish of all types. I can t stand the thought of having it in my house. _8 _ Brown bread doesn t taste as good as white bread. _3 I only use organic food because it is so much healthier. _9 _ She s my little vegetarian! She ll eat anything other than meat. _2 Rice milk is the only type of milk that I serve my family. We try to stay as close to a vegan diet as possible. _1 I rarely use eggs.
Practice Activity -D 1. Talk to your WIC Coordinator about your agency s procedures for managing medical documentation requests. 2. Learn where Medical Documentation forms are kept on file in your clinic and who oversees this process. 3. Ask other CPAs how they handle a request for whole milk for a child over 2 years of age that does not meet qualifying conditions for whole milk. Skill Check-#6 1. Women, children and infants on a medical formula receive Food Package 3. 2. What are 2 qualifying conditions which allow an infant to receive a medical formula? Any 2 of the following: Premature birth, Low birth weight, Failure to Thrive, Metabolic disorders, Gastrointestinal disorders, Malabsorption syndromes, Immune system disorders, Life threatening disorders 3. What are 2 qualifying conditions which allow a woman to receive a medical formula? Any 2 of the following: Metabolic disorders, Gastrointestinal disorders, Malabsorption syndromes, Immune system disorders, Life threatening disorders 4. What are 2 non-qualifying conditions for issuance of medical formula to a woman? Any 2 of the following: Enhancing nutrient intake or managing body weight, Lactose intolerance, Personal preference, Food dislike 5. What are 3 qualifying conditions which allow a child to receive soy beverage? Any 3 of following: Confirmed milk allergy, Vegan/vegetarian diet, Severe lactose maldigestion, Medical condition requiring soy-based drink, Religious observance, Cultural use of food 6. What are 3 non-qualifying conditions for issuance of tofu to a child?
Participant preference, Food dislike, Suspected or unconfirmed allergy 7. How much tofu may a woman in FP 5 receive without medical documentation? 4 pounds How much soy beverage? 22 quarts 8. What 5 criteria must be included in Medical Documentation? 1. Qualifying conditions 2. Name of formula or supplemental food 3. Prescribed amount/day 4. Length of time required 5. Health Care Provider signature, date and contact information 9. What document should be used to identify the maximum amount of formula available in a food package category? The MN WIC Formula Amounts Guide for Medical Formula 10. What is an option if the CPA is unable to obtain written documentation in a timely manner? You may obtain an initial verbal OK from the Health Care Provider. Written confirmation must be received within 1 month. Skill Check-#7 1. For homeless participants, milk is available in what size container? Quarts 2. Which whole grain options may be better for homeless participants? Whole grain bread and tortillas do not require any preparation.
Refer to the WIC Shopping Guide to answer the following questions: 1. Canned fruit with added sugar is not allowed. T 2. Frozen fruit with an artificial sweetener like Splenda is allowed. F 3. No potatoes, except sweet potatoes and yams, are allowed. T 4. A 64-oz container of 100% apple juice must have 120% of daily vitamin C per serving. 5. Boil-in-bag brown rice is allowed. F 6. WIC-allowed whole grain cereal is defined as more than 51% whole grain. T 7. Whole and 2% milk are only allowed when listed on the voucher. T Refer to MOM Chapter 7 and the text of this module to answer the following questions: 8. 9. A mom of a Fully-Breastfed infant (receiving no formula) is eligible for Food Package 7. An 8-month infant with no qualifying conditions is eligible for Food Package 3. 10. A four-year-old child is eligible for Food Package 4. T 11. A mom of a 7-month infant receiving 3 cans of powdered contract formula is eligible for Food Package 5. 12. All infants are eligible for infant meats. F 13. Only standard contract formula is available in Food Packages 1 and 2. T 14. Final Skill Check Written Medical Documentation from a Health Care Provider licensed to write medical prescriptions is required for issuance of a medical formula. T T F T T